Mechanisms of the effects of prone positioning in acute respiratory distress syndrome

被引：89

作者：

Guerin, C. ^{[1
,2
,3
]}

Baboi, L. ^{[1
]}

Richard, J. C. ^{[1
,2
,3
]}

机构：

[1] CHU Lyon, Hop Croix Rousse, Serv Reanimat Med, F-69004 Lyon, France

[2] Univ Lyon, Lyon, France

[3] INSERM, Creatis, Villeurbanne, France

来源：

INTENSIVE CARE MEDICINE | 2014年 / 40卷 / 11期

关键词：

Acute respiratory distress syndrome (ARDS); Prone position; Mechanical ventilation; Ventilator-induced lung injury; END-EXPIRATORY PRESSURE; ACUTE LUNG INJURY; INHALED NITRIC-OXIDE; GAS-EXCHANGE; REGIONAL-DISTRIBUTION; ESOPHAGEAL PRESSURE; VENTILATION; PERFUSION; RECRUITMENT; OXYGENATION;

D O I：

10.1007/s00134-014-3500-8

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Prone positioning has been used for many years in patients with acute respiratory distress syndrome (ARDS). The initial reason for prone positioning in ARDS patients was improvement in oxygenation. It was later shown that mechanical ventilation in the prone position can be less injurious to the lung and hence the primary reason to use prone positioning is prevention of ventilator-induced lung injury (VILI). A large body of physiologic benefits of prone positioning in ARDS patients accumulated but these failed to translate into clinical benefits. More recently, meta-analyses and randomized controlled trial in a specific subgroup of ARDS patients demonstrated that prone positioning can improve survival. This review covers the effects of prone positioning on oxygenation, respiratory mechanics, and VILI. We conclude with the effects of prone positioning on patient outcome, in particular on survival.

引用

页码：1634 / 1642

页数：9

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